This Phase I project is motivated by current issues associated with screening for retinopathy of prematurity (ROP). ROP is the leading cause of blindness in infants. In recent years the number of infants at risk for ROP has been increasing. In the United States, the rate of prematurity has risen from 9.4% of all births in 1981 to 12% in 2010, for a total of over 500,000 preterm births. Neonate disease management depends largely on timely screening and intervention. Unfortunately, low reimbursement levels for ROP screening, insufficient equipment for ROP screening in remote locations, and long-term exposure to medical malpractice actions make it difficult to provide appropriate care to neonates at risk. To mitigate these problems, Vision Quest Biomedical LLC and its collaborators, Oakland University (MI) and the Retina Institute of South Texas (RIST) will demonstrate and test NeoScan, a software system for automatic ROP screening that provides improved retinal image quality and accurate quantification of vasculature tortuosity and caliber, factors that have been demonstrated to correlate with the presence of advanced stages of ROP. The objectives of NeoScan are to reduce variability in the diagnosis of advanced stages of ROP and to provide a tool for accurate screening of neonates. This project will impact public health at multiple levels. The societal significance of this project is manifested by the large number of neonates that require ROP screening, and the current difficulties to access ROP care in remote and underserved locations. Through the development of NeoScan, we will be able to provide appropriate and widespread ROP screening. The economic significance is evidenced by the cost-effectiveness studies that have shown that appropriate treatment for ROP would lead to annual savings of $500 million. The commercial impact of tele-screening using the NeoScan will also be very high, allowing ROP screening to become affordable and widespread.